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Renal dysfunction in children with uncomplicated, Plasmodium falciparum malaria in Tamale, Ghana

G D Burchard1, S Ehrhardt, F P Mockenhaupt

  • 1Institut für Tropenmedizin Berlin, Charité, Humboldt-Universität Berlin, Spandauer Damm 130, 14050 Berlin, Germany. gerd.buchard@bni-hmburg.de

Annals of Tropical Medicine and Parasitology
|July 2, 2003
PubMed

Insights

In Ghana, cystatin C revealed that 17% of children with malaria had impaired kidney function. Proteinuria patterns suggest both glomerular and tubular damage are common in Plasmodium falciparum malaria.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Clinical Biochemistry

Background:

  • Malaria, particularly Plasmodium falciparum, is a significant health concern in endemic regions like Ghana.
  • Renal dysfunction is a recognized complication of severe malaria, but its prevalence in uncomplicated cases is less understood.
  • Cystatin C is emerging as a sensitive biomarker for assessing glomerular filtration rate (GFR).

Purpose of the Study:

  • To estimate the frequency of renal dysfunction in children with uncomplicated Plasmodium falciparum malaria using cystatin C.
  • To investigate patterns of proteinuria, including albumin, immunoglobulin G, and alpha1-microglobulin, in these children.
  • To determine the extent of glomerular and tubular damage in the context of P. falciparum malaria.

Main Methods:

  • A study was conducted in Tamale, Northern region, Ghana, involving 78 children with uncomplicated P. falciparum malaria.
  • Plasma cystatin C levels were measured to estimate glomerular filtration rate (GFR).
  • Urinary excretion of albumin, immunoglobulin G, and alpha1-microglobulin was analyzed to assess proteinuria.

Main Results:

  • Elevated plasma cystatin C concentrations, indicative of subclinical renal impairment, were observed in 17% of the studied children.
  • The majority of children (85%) exhibited proteinuria with both glomerular and tubular patterns.
  • These findings suggest significant involvement of both glomerular and tubular structures.

Conclusions:

  • Subclinical renal dysfunction is prevalent in children with uncomplicated Plasmodium falciparum malaria in Ghana.
  • The common occurrence of dual glomerular and tubular proteinuria indicates that P. falciparum malaria frequently causes damage to both parts of the nephron.
  • Cystatin C is a valuable tool for detecting early-stage renal impairment in pediatric malaria cases.

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